Mrs. Miller has now been participating in inpatient rehabilitation for 10 weeks, and her progress has slowed compared to the gains she made initially. Therapists and nursing staff have noticed her mood is low. She frequently complains of fatigue, trouble concentrating, and generally feeling down. She has started to lose weight. She attends her therapy sessions, but is otherwise sleeping throughout the day with the curtains drawn in her room. She is not participating in any recreation and leisure activities, and declines weekend outings.

Her family is concerned that she is not herself these last couple of weeks – it is ‘not like her’ to sleep for 12 hours per day, so they ask the medical team if this could be related to an illness. At rounds, the interdisciplinary team raises the possibility of depression.